| NPI | 1033637020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 5377838091) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017030712) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017030712) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-77838-091) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-07-21 |